1. (a) Nephrectomy (removal of part or all of the kidney).

   1. (1) Incomplete removal of stone(s) or tumor, if present.
   2. (2) Blockage of urine (risk of partial nephrectomy).
   3. (3) Leakage of urine at surgical site.
   4. (4) Injury to or loss of the entire kidney (risk of partial nephrectomy, intentional for total or radical nephrectomy)
   5. (5) Loss of the adrenal gland (gland on top of the kidney that makes certain hormones/chemicals the body needs) - intentional in the case of radical nephrectomy.
   6. (6) Damage to organs next to kidney.

2. (b) Nephrolithotomy and pyelolithotomy (removal of kidney stone(s)).

   1. (1) Incomplete removal of stone(s).
   2. (2) Blockage of urine.
   3. (3) Leakage of urine at surgical site.
   4. (4) Injury or loss of the kidney.
   5. (5) Damage to organs next to kidney.

3. (c) Pyeloureteroplasty (pyeloplasty or reconstruction of the kidney drainage system), Ureteroplasty (reconstruction of ureter (tube between kidney and bladder)).

   1. (1) Blockage of urine.
   2. (2) Leakage of urine at surgical site.
   3. (3) Injury to or loss of the kidney (pyeloureteroplasty) or ureter (ureterolithotomy).
   4. (4) Damage to organs next to kidney.
   5. (5) Incomplete removal of the stone or tumor (when applicable).

4. (d) Ureterolithotomy (surgical removal of stone(s) from ureter (tube between kidney and bladder)).

   1. (1) Leakage of urine at surgical site.
   2. (2) Incomplete removal of stone.
   3. (3) Blockage of urine.
   4. (4) Damage to organs next to ureter (tube that carries urine from kidney to bladder).
   5. (5) Damage to or loss of ureter (tube that carries urine from kidney to bladder).

5. (e) Ureterectomy (partial/complete removal of ureter tube that carries urine from kidney to bladder), Ureterolysis (partial/complete removal of ureter (tube that carries urine from kidney to bladder) from adjacent tissue).

   1. (1) Leakage of urine at surgical site.
   2. (2) Incomplete removal of stone (if stone present).
   3. (3) Blockage of urine.
   4. (4) Damage to organs next to ureter.
   5. (5) Damage to or loss of ureter (ureterolysis).

6. (f) Ureteral reimplantation (reinserting ureter (tube between kidney and bladder) into the bladder).

   1. (1) Leakage of urine at surgical site.
   2. (2) Blockage of urine.
   3. (3) Damage to or loss of ureter.
   4. (4) Backward flow of urine from bladder into ureter.
   5. (5) Damage to organs next to ureter.

7. (g) Prostatectomy (partial or total removal of prostate).

   1. (1) Leakage of urine at surgical site.
   2. (2) Blockage of urine.
   3. (3) Incontinence (difficulty with control of urine flow).
   4. (4) Semen passing backward into bladder.
   5. (5) Difficulty with penile erection (possible with partial and probable with total prostatectomy).

8. (h) Total cystectomy (removal of bladder).

   1. (1) Probable loss of penile erection and ejaculation in the male.
   2. (2) Damage to organs next to bladder.
   3. (3) This procedure will require an alternate method of urinary drainage (urine will need a new place to collect or empty from the body).

9. (i) Radical cystectomy.

   1. (1) Probable loss of penile erection and ejaculation in the male.
   2. (2) Damage to organs next to bladder.
   3. (3) This procedure will require an alternate method of urinary drainage (urine will need a new place to collect or empty from the body).
   4. (4) Chronic (continuing) swelling of thighs, legs and feet.
   5. (5) Recurrence or spread of cancer if present.

10. (j) Partial cystectomy (removal of a portion of the bladder).

    1. (1) Leakage of urine at surgical site.
    2. (2) Incontinence (difficulty with control of urine flow).
    3. (3) Backward flow of urine from bladder into ureter (tube between kidney and bladder).
    4. (4) Blockage of urine.
    5. (5) Damage to organs next to bladder.

11. (k) Cystolithotomy (surgical removal of stone(s) from the bladder).

    1. (1) Injury to bladder or surrounding organs.
    2. (2) Urinary incontinence (inability to control release of urine from bladder).

12. (l) Cystolitholapaxy (cystoscopic crushing and removal of bladder stone(s)).

    1. (1) Injury to bladder.
    2. (2) Scarring/injury of urethra (tube from bladder to outside).
13. (m) Cystostomy (placement of tube into the bladder). Injury to bladder or surrounding organs.

14. (n) Diverticulectomy of the bladder (removal of outpouching of the bladder).

    1. (1) Injury to bladder or surrounding organs.
    2. (2) Urinary incontinence (inability to control release of urine from bladder).

15. (o) Urinary diversion (ileal conduit, colon conduit).

    1. (1) Blood chemistry abnormalities requiring medication.
    2. (2) Development of stones, strictures (scars or narrowings) or infection in the kidneys, ureter or bowel (intestine).
    3. (3) Leakage of urine at surgical site.
    4. (4) This procedure will require an alternate method of urinary drainage (urine will need a new place to collect or empty from the body).

16. (p) Ureterosigmoidostomy attachment of ureters (tubes between kidney and bladder to the colon (large intestine)).

    1. (1) Blood chemistry abnormalities requiring medication.
    2. (2) Development of stones, strictures or infection in the kidneys, ureter or bowel (intestine).
    3. (3) Leakage of urine at surgical site.
    4. (4) Difficulty in holding urine in the rectum.

17. (q) Urethroplasty (construction/reconstruction/dilation of drainage tube from bladder to the outside).

    1. (1) Leakage of urine at surgical site.
    2. (2) Stricture formation (narrowing of urethra (tube from bladder to outside)).
    3. (3) Need for additional surgery.

18. (r) Diverticulectomy or diverticulotomy of the urethra (repair or drainage of outpouching of the urethra).

    1. (1) Injury to urethra (tube from bladder to outside) with leak of urine or narrowing of urethra.
    2. (2) Fistula formation (connection between urethra and other pelvic structure).
    3. (3) Sexual dysfunction (pain with sexual intercourse, change in sensation with sex).

19. (s) Percutaneous nephrostomy/stenting/stone removal.

    1. (1) Pneumothorax or other pleural complications (collapsed lung or filling of the chest cavity on the same side with fluid).
    2. (2) Septic shock/bacteremia (infection of the blood stream with possible shock/severe lowering of blood pressure) when pyonephrosis (infected urine in the kidney) present.
    3. (3) Bowel (intestinal) injury.
    4. (4) Blood vessel injury with or without significant bleeding.

20. (t) Lithotripsy ("Shockwave Lithotripsy") (sound wave removal of stones from kidney and ureter).

    1. (1) Injury to kidney, ureter (tube between kidney and bladder), or other nearby organs.
    2. (2) Stone fragments blocking ureter.
    3. (3) Bleeding in or around kidney or ureter.

21. (u) Dialysis (technique to replace functions of kidney and clean blood of toxins).

    1. (1) Hemodialysis.

       1. (A) Hypotension (low blood pressure).
       2. (B) Hypertension (high blood pressure).
       3. (C) Air embolism (air bubble in blood vessel) resulting in possible death or paralysis.
       4. (D) Cardiac arrhythmias (irregular heart rhythms).
       5. (E) Infections of blood stream, access site, or blood borne (for example: Hepatitis B, C, or HIV).
       6. (F) Hemorrhage (severe bleeding as a result of clotting problems or due to disconnection of the bloodline).
       7. (G) Nausea, vomiting, cramps, headaches, and mild confusion during and/or temporarily after dialysis.
       8. (H) Allergic reactions.
       9. (I) Chemical imbalances and metabolic disorders (unintended change in blood minerals).
       10. (J) Pyrogenic reactions (fever).
       11. (K) Hemolysis (rupture of red blood cells).
       12. (L) Graft/fistula damage including bleeding, aneurysm, formation (ballooning of vessel), clotting (closure) of graft/fistula.

    2. (2) Peritoneal dialysis.

       1. (A) Infections, including peritonitis (inflammation or irritation of the tissue lining the inside wall of abdomen and covering organs), catheter infection and catheter exit site infection.
       2. (B) Development of hernias of umbilicus (weakening of abdominal wall or muscle).
       3. (C) Hypertension (high blood pressure).
       4. (D) Hypotension (low blood pressure).
       5. (E) Hydrothorax (fluid in chest cavity).
       6. (F) Arrhythmia (irregular heart rhythm).
       7. (G) Perforation of the bowel (hole in intestine).
       8. (H) Sclerosis or scarring of the peritoneum (lining of the abdomen) with loss of dialysis function.
       9. (I) Weight gain leading to obesity.
       10. (J) Abdominal discomfort/distension.
       11. (K) Heartburn or reflux.
       12. (L) Increase in need for anti-diabetic medication.
       13. (M) Muscle weakness.
       14. (N) Dehydration (extreme loss of body fluid).
       15. (O) Chemical imbalances and metabolic disorders (unintended change in blood minerals).
       16. (P) Allergic reactions.
       17. (Q) Nausea, vomiting, cramps, headaches, and mild confusion during and/or temporarily after dialysis.

Source Note:The provisions of this §602.16 adopted to be effective December 26, 2023, 48 TexReg 7985; amended to be effective May 25, 2025, 50 TexReg 2968.